Fernando Giovanella
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A guide for patients who live abroad

After you fly home: who looks after your zygomatic implants, and what happens if something goes wrong

At Dr. Fernando Giovanella's clinic in Blumenau, Brazil, the question international patients ask most isn't about the surgery. It's about the week after the flight home: who looks after these implants when the surgeon is on another continent — and what happens if something goes wrong? If you're reading this for a parent, it was written for you as much as for them.

You've probably already read the warnings. In a 2022 survey by the British Dental Association, 86% of dentists said they had treated patients who developed problems after dental treatment abroad.9 In a 2009 survey of 440 Irish dentists, 76% said they had seen such patients in the previous twelve months.10 And the Oral Health Foundation, citing a Which? report, says more than a quarter of people who traveled abroad for medical treatment felt they didn't get the follow-up care they needed, and a further 18% reported complications.11

I'm not going to argue with those numbers; they're the reason this page exists. Far from home, follow-up is the part most likely to be left to chance — and a page that says "full aftercare" and stops there has left it to chance too. This one doesn't stop there. At the end there's a section written to your dentist, not to you. Show it to them.

If I get zygomatic implants abroad, what happens when I'm back home?

After zygomatic implants with Dr. Fernando Giovanella in Blumenau, Brazil, you fly home with an implant passport and a letter for your dentist. WhatsApp messages get a written reply from Andreza at the clinic the same business day, Monday to Friday. You come back once, at three to four months, for a planned check. Your dentist at home does the cleaning, check-ups and most bridge repairs; an implant problem means coming back, and the written warranty covers the work, under its conditions — not the trip.

What is an implant passport, and what should it include?

An implant passport is the document that lets a dentist who has never met Dr. Fernando Giovanella, in Blumenau, Brazil, open your mouth and know exactly what he's looking at — and every international patient leaves with one, in English, printed and as a PDF. It's filled in from the labels on the implant boxes on the day of surgery and signed by me before you fly; at your return visit, three to four months later, it's brought up to date and you get the new PDF.

Implant passportEnglish
Clínica Dr. Fernando Giovanella · Blumenau, Brazil
Patient
Surgery date
Surgeon · CRO-SC
Clinic address
  • Implant 1
    Manufacturer · system
    Length × diameter
    Position (tooth chart)
    Zygomatic or conventional
    Lot number
    Connection type
    Multi-unit abutment
    Screw · torque (Ncm)
  • Implant 2, 3 … — one block for every implant placed
  • Also recorded
    Prosthesis · design and material
    Graft material, if any
    Manufacturer's MRI statement
    Written warranty · care instructions
Enclosed: post-operative CBCT and radiograph (DICOM) · a signed letter to your dentist, with a direct channel
The document itself. A model, with no patient in it. The table below says what each line records and why your next dentist needs it.

A line on an invoice that says "titanium implant" is not a passport; your dentist can't act on it. What they need is the part number, the lot, the connection, the screw and the torque — what decides whether the driver in their drawer fits yours. The model, with no patient in it:

FieldWhat it recordsWhy the next dentist needs it
Manufacturer and line (system)the system you received — Neodent Zygoma GM (Straumann Group) or, in some zygomatic cases chosen on your scan, S.I.N. Zygomatic — with the manufacturer's address and website20,21Which parts, which catalogue, which representative
Length and diameterof each implant, in millimetersMakes sense of the X-ray
Position of each implanton a tooth chart; zygomatic or conventionalWhich screw hole leads where
Lot numberof every implant placedTraceability to the manufacturer
Connection typethe interface between implant and abutmentWhich abutments and screws fit
Abutmentmulti-unit abutment: brand, height, angulationMost likely to need a replacement one day
Screws and torquewhich screw where, and its torque in NcmA loose screw retightened to the right value
Date, clinic and surgeonsurgery date; clinic address; surgeon's name and CRO-SC numberWho to call; how to check the registration
Post-operative CBCT and radiographin DICOM, on a USB drive, which any clinic can openThe baseline for every later image
Prosthesis design and materialmaterial, and where the screw-access holes areHow to open, repair and close it
Graft material, if anybrand and type, or "none"Explains the X-ray beside the implant
The manufacturer's MRI statementMR Conditional, with the maker's conditions copied in: field strength (1.5 T and 3 T for Neodent; 3 T for S.I.N.), gradient and SAR limits18,20,21The radiologist's first question, answered
Written warranty and care instructionswhat is covered, for how long; how to clean the bridgeThe rule in writing
A letter to your dentistsigned by the surgeon, with the clinic's WhatsApp and e-mailFirst contact colleague to colleague

If you live in the European Union, some of this will look familiar. Under the EU medical device regulation, in force since May 2021, hospitals and clinics in the EU must give patients an implant card with any implanted device; dental implants are not on the article's list of exemptions, though one member state has read it otherwise.7 The position of the Council of European Dentists is that a dentist who places a dental implant should supply the patient with an implant card.8 My clinic is in Brazil and isn't governed by that regulation — but the problem the card solves has nothing to do with borders. A dentist in your own town who inherits an implant with no record faces the same wall.

The passport tells your dentist what's there. Whether they can do anything about it is a less tidy question.

Will a dentist in my country be able to work on these implants?

It depends on one thing more than any other — whether the parts for the system Dr. Fernando Giovanella uses in Blumenau, Brazil, are sold and cleared in your country — and that is a fact I'd rather state than leave you to assume. I use Neodent, part of the Straumann Group, in most cases, and S.I.N. in some zygomatic cases, chosen on your scan — your passport names the system you received. Neodent's zygomatic implants are cleared by the U.S. FDA — in 2019, and again in 2023 for the current GM system16 — and licensed by Health Canada19. S.I.N.'s too, line by line: the Zygomatic Plus licensed by Health Canada in 202519, the newer Tapered Pro Conical Zygoma cleared by the FDA in November 202517. Neodent parts are sold through the Straumann Group's own Neodent shops in the United States, Canada, the United Kingdom and Australia; the U.S. shop lists a zygomatic implant, an abutment and its screw in stock24. A passport that names a part nobody in your country can order only informs.

The systems, and why these two. No ranking here. Paperwork — because paperwork is what follows you home. Both makers' current zygomatic implants are listed as MR Conditional; the conditions go in your passport18,20,21. Neodent's also carries a 2019 FDA clearance specifically for MRI compatibility16. Neodent's quality system is certified to ISO 13485, valid to November 202722, and Neodent publishes a patient implant card for its Zygoma system20,21. Lengths run from 30 to 55 mm (Neodent) and 30 to 62.5 mm (S.I.N.): the implant is chosen to fit you, not the reverse20,21. Each maker runs a warranty program — Neodent's: no end date on the implant itself, ten years on abutments and metal restorations, five on ceramic restorations; S.I.N.'s: work done in Brazil, which yours would be — replacement of the part, under its conditions25. The clinic's own written warranty is a separate document, below. And the owners — a Swiss group since 2015, Henry Schein since 202323 — matter for one reason: the parts and the paperwork outlive any single clinic, mine included.

What does a dentist at home actually do with zygomatic implants? Rarely anything to the implant itself: anchored in the cheekbone, it isn't something a general dentist is expected to touch, and it isn't something that usually needs touching. What needs attention over the years is the bridge and the abutments on top — a loose screw, a chipped tooth, the cleaning, a replacement screw — and those are the parts that need to be on a shelf in your country. The one thing your dentist needs that isn't a part is knowing what to refer: because the implant travels beside the maxillary sinus, a sinus symptom on that side is the finding I ask every home dentist to send back to me rather than treat as an ordinary sinus complaint. The signs are below; the letter in your passport says the same to them.

And if your dentist would rather not take it on, or charges for it? Both are fair. I won't promise you a "partner dentist" in your country I don't have under contract. What I can tell you is the rule for the fee: the clinic reimburses your dentist's fee up to US$ 100 a year, for a repair the written warranty covers, if you tell us first and send the receipt and the X-ray; otherwise the fee is yours.

Who do I ask "is this normal?" once I'm home, and how fast will I hear back?

You ask Andreza, who answers patients' messages at Dr. Fernando Giovanella's clinic in Blumenau, Brazil — on WhatsApp, in English — and you have a written answer the same business day. Messages are answered Monday to Friday, 8:30 a.m. to 5 p.m. Brasília time (UTC−3) — in New York, 7:30 a.m. to 4 p.m. for most of the year. Anything clinical is answered by me, in my words. If a photo or X-ray would help, you'll be asked for one; if it needs a call, you'll get a call.

The shape of the promise
  1. 1Something doesn't feel normalIf you're wondering whether to write, write.
  2. 2You write on WhatsAppto Andreza, at the clinic · Monday to Friday, 8:30 a.m.–5 p.m. Brasília time (UTC−3)
  3. 3A written reply the same dayAnything clinical: the surgeon, in his own words. A photo or an X-ray, if it would help.
  4. 4The next stepA call, if it needs one. Otherwise, your planned return to Blumenau, three to four months after surgery.
A name, the same day, one channel. The three things on this page you can hold the clinic to.

Then there's the visit you don't have to ask for. Three to four months after surgery you come back to Blumenau, as planned from the start, so I can check that the bone has grown onto each implant — what surgeons call osseointegration — and finish your final teeth, if they weren't finished on the first trip, or make any final adjustments. Plan at least three days for it. The appointment exists before any problem does. Between the two trips nothing else is scheduled — no video check-ins — but the line above stays open the whole time, and if something needs a call, a call is booked.

Most of what I'm asked in the first weeks turns out to be normal — swelling that takes its time, a face that feels different on one side, a bridge that doesn't yet feel like yours. I'd rather answer ten of those than miss the one that isn't. If you're wondering whether to write, write.

An answer the same business day, which you can hold me to, is worth more than a word nobody checks. Next: three lists, and no fourth called "we'll see".

What can be handled remotely, what can my local dentist do, and when would I need to come back?

Three lists — and Dr. Fernando Giovanella, in Blumenau, Brazil, would rather they were honest than long.

From here, without anyone traveling: the "is this normal?" question, with a photo or X-ray when it helps; reading any image you or your dentist send; deciding with your dentist what the next step is; the written opinion when two dentists disagree (next section); guidance on cleaning and the bridge. Most of what happens after surgery lives here.

Your dentist at home, with the passport and the parts: cleaning and check-ups at the intervals we suggest; a loose prosthetic screw, tightened to the torque in the passport; a chipped tooth repaired; an abutment screw replaced; the X-ray we ask for; a first look at any sinus symptom, then sent my way. None of this needs a zygomatic specialist — it needs a dentist who works with implant-supported bridges, the document, and a part they can order (which parts, and where they're sold).

Coming back to Blumenau: first, the visit that's planned — three to four months after surgery, for at least three days, to check how the implants have taken in the bone and finish or adjust your final teeth; not a problem, but the plan, agreed before your first flight. Beyond that: a zygomatic implant that fails to integrate, or an infection that doesn't settle with treatment at home; a bridge that must be remade rather than repaired.

The third list is short on purpose. It's also the one whose cost nobody prints. So here it is, in writing.

If something goes wrong, who pays for the trip back, and what is covered?

The work is covered by a warranty from Dr. Fernando Giovanella's clinic in Blumenau, Brazil — three years on the implants and two years on your final teeth, under the conditions in the written warranty — and the trip back is not: you pay the flights and the hotel, and the time is your own. I'd rather tell you that now than have you find it out at the worst moment. Elsewhere, the word you're probably looking for can mean a price match, or a promise with no end date and no condition you can read. I'll use neither. Here you get an end date, conditions you can read, and the table below.

Handled from hereHandled by your dentist at homeRequires coming back to Blumenau
Whatquestions, images, written opinions, the plan for the next stepcleaning, check-ups, a loose screw, a chipped tooth, a replacement screw, the X-ray we ask fora failing zygomatic implant; an infection that doesn't settle; a bridge that must be remade on the implants
Who decidesI do, with youyour dentist, with my opinion whenever they want itI do, after seeing the images — never from a phone call alone
What it costs younothingyour dentist's fee — reimbursed up to US$ 100 a year, for a repair the written warranty covers, if you tell us first and send the receipt and the X-raythe two rows below
The work itself——covered: three years on the implants and two years on your final teeth, under the conditions in the written warranty; if a repair needs them, anesthesia and hospital — and, when an implant is replaced, the laboratory, the clinic's operating costs (chair time, staff and materials) and a new implant with its abutments — are quoted to you first, unless the manufacturer replaces the part at no cost under its own warranty program
Flights, hotel and your time——not covered — yours to pay, and the same for anyone traveling with you

The written warranty. You have it in writing before you book a flight, as part of your treatment contract. In short: a yearly check — here, or by your dentist at home with an X-ray sent to us; tell us within 30 days of noticing a problem; nobody else alters the implants without our written OK, except in an emergency — routine care by your dentist is fine; and the usual exclusions, such as an accident or not wearing a night guard you were prescribed. Read the full warranty before you fly, not after. If a sentence in it isn't clear, ask me to explain it. A warranty you can't explain to your own dentist isn't worth much.

Two dentists, two opinions. Nobody writes about this, and it happens: your dentist at home looks at an X-ray and sees bone loss; I look at the same image and see a loose screw. You shouldn't be the referee. Send me their X-ray or CBCT, with their note. You'll have a written reply the same business day. If the images need a closer look, a full written opinion follows, in words your dentist can check against the image. If they're right and it's something the warranty covers, it's handled under the warranty — repaired here, or by them, with their fee reimbursed up to the limit in the warranty. If I'm right, I'll say why — to them, not only to you. Either way you end with two dentists agreeing on paper, the only outcome that helps you.

A rule you can read, a plan you hold in writing, and a surgeon whose registration you can look up: that is what you hold us to. how to check the surgeon's registration

What's left is knowing when to use any of it.

What signs should I watch for after zygomatic implant surgery?

The sinus first. A zygomatic implant travels beside the maxillary sinus on its way to the cheekbone, and sinusitis is the complication the literature reports most often — rates range from about 2–4% to 14%, and depend strongly on surgical technique1,2,5 — which is why Dr. Fernando Giovanella, in Blumenau, Brazil, would rather you know the signs than be surprised by them. Those are pooled numbers from many surgeons and techniques, not mine — and most of the distance between the two ends of that range is the technique (why the technique matters, further down). What belongs here is what you do at home.

Schematic, not to scale · front view, one side · volumes, not anatomy
Why the sinus comes first. The implant runs along the outer wall of the sinus on its way to the cheekbone. The lowest sinusitis rates in the literature belong to techniques that keep the implant outside the sinus, and the approach used here is planned on the CBCT to follow that outer wall. Any sinus symptom on that side is still the first thing to report.

Write to us the same day. A feeling of pressure or fullness on one side of the face that builds instead of fading. Discharge from one nostril, or a bad taste or smell that keeps coming back. Swelling that was going down and comes back up. A bridge that moves when you press it, or a screw you can see or feel. Pain that is getting worse rather than better after the first days.

Mention it in your next message. Numbness or tingling in the cheek or upper lip that is slowly improving. A tooth on the bridge that chipped. Food catching in a place it didn't before. A feeling that one side is "different", without any of the signs above.

Seek care where you are, now — then tell us. Fever with facial swelling, swelling around the eye, bleeding that won't stop, trouble breathing or swallowing: emergencies after any surgery, in any country — the nearest emergency department first, then the clinic's WhatsApp.

In every case the channel is the same: Andreza on WhatsApp, and a written reply the same business day. If you're on the first list and it's after hours in Brazil, write anyway: your message is the first one read when the clinic opens. If it gets worse before that, go to the emergency department where you are. Don't wait to see whether it goes away; the easiest sinus problem to treat is the one I hear about early.

The fairer question — the one to ask before you book a flight — is how often any of it happens.

How safe is zygomatic implant surgery?

Safer than "a screw into the cheekbone" sounds, and less simple than a page with no risks on it would have you believe — which is why Dr. Fernando Giovanella, in Blumenau, Brazil, would rather you read the literature's numbers than his. These are the studies, not my results.

95.21%still in place at 12 years · 4,556 zygomatic implants in 2,161 patients · 68 studies, 2016 review1
96.2%survival at 6 years · 98.1% when the teeth were fixed straight after surgery, 95.0% when fixed later · 2023 meta-analysis2
96.5vs 95.8%zygomatic against conventional implants, five years or more · no significant difference3
2–4%to 14%sinusitis, the complication reported most often · the range across studies; depends strongly on surgical technique1,2,5
What the studies report — not this clinic's results. Pooled across many surgeons and techniques; not a promise about your case.

Survival first. A 2016 systematic review pooled 68 studies — 4,556 zygomatic implants in 2,161 patients — and found 95.21% of the implants still in place at twelve years.1 A 2023 meta-analysis put survival at 96.2% at six years, higher when the teeth were fixed to the implants straight after surgery (98.1%) than when they were fixed later (95.0%).2 And a review of studies that followed patients for five years or more found no significant difference between zygomatic and conventional implants: 96.5% against 95.8%.3

"Survival" is a narrow word: the implant is in place and in use. It doesn't count a sinus infection that was treated, a screw that was tightened or a bridge that was remade. For those, the honest source is the newest one — and the least reassuring.

In 2026 a Cochrane review set zygomatic implants against the alternative, a bone graft followed by conventional implants, and found that at three years the zygomatic route probably loses fewer implants and gets you to fixed teeth sooner — and probably brings more complications along the way. One randomized trial; moderate-certainty evidence.4 That is the trade in one sentence: the anchor holds, and the sinus needs watching. It's why the previous section exists.

Why the technique matters more than the implant. The range in the previous section isn't luck. It's mostly the route the implant takes. A 2024 meta-analysis sorted the studies by route; the sinusitis rate moved with it: 21.62% with the sinus slot technique, 4.36% with the intrasinus technique and, with the extrasinus technique — the implant kept outside the sinus — a reported 0.00% (statistical margin up to 1.22%).5 One group went further. In a 2010 prospective study, surgeons lifted the sinus membrane away first and placed 37 zygomatic implants in 16 patients completely outside the sinus; over six to 24 months, none failed and no sinusitis was reported.15 Sixteen patients, one team, two years: not a rule, and I won't read it as one. It shows the principle I plan around: keep the implant out of the sinus.

With SkinGuide Zygoma®, each implant's path is drawn on your CBCT before surgery, from the teeth you'll have to the anchorage point in the cheekbone. On the day, a thin printed guide of my own design transfers that path to the bone, so the implant follows the outer wall of the sinus, according to each patient's anatomy, with no large window opened into it. Those rates belong to the techniques the studies measured, not to the SkinGuide approach or to me — and people with no implants get sinusitis too. The route is decided on a screen, not in the chair.

Where the surgery happens, and who gives the anesthesia, is part of how safe it is; ask it of anyone. In my case it's intravenous sedation, given and monitored by a physician anesthesiologist, or — when general anesthesia is the better choice — day surgery at Hospital Unimed Blumenau; see where the surgery is done, and who gives the anesthesia.

When can you fly home? Here is what's published, and its limits. A 2023 review in the British Dental Journal suggests waiting at least 72 hours before flying after implant placement (one week recommended), and at least two weeks after a sinus lift (six weeks recommended).6 The authors say so themselves: there is little research, most of it on military aircrew, and the figures are a starting point for the clinician, not a rule. Nothing published addresses zygomatic implants and a long flight specifically. So what follows is my plan, labeled as mine: the first trip lasts at least seven days, so you don't fly before the week that review recommends after implant placement. However long your flight, you're released for it in person, at the last review before you leave — not by a page.

If you're still weighing a graft, see how zygomatic implants compare with bone grafting. And whether you need zygomatic implants at all starts with a scan, not a photo.

A written reading of your CBCT by the surgeon who would operate, preliminary until I examine you in person — with the follow-up on this page part of the plan from the first message. The message includes your consent to how the clinic handles health data — read it first. how treatment is sequenced when you live in another country

I'm this patient's dentist. What will I receive, and how do I reach the surgeon?

If you're reading this because a patient of yours is considering, or has had, zygomatic implants with Dr. Fernando Giovanella in Blumenau, Brazil, this section is for you — colleague to colleague — and it starts with what lands on your desk.

On your desk
Implant passportfilled in · in English
Plan, CBCT and radiographpost-operative · DICOM · on a USB drive
Post-operative protocolreview intervals · the radiographs to send
A signed letterfrom the surgeon · a direct channel: the clinic's WhatsApp and e-mail

What you receive. The implant passport above, filled in — Neodent Zygoma GM (Grand Morse connection) or S.I.N. Zygomatic, with part and lot numbers and the catalogue they belong to20,21. The surgical plan, and the post-operative CBCT and panoramic radiograph in DICOM, on a USB drive. A written post-operative protocol, with the review intervals I suggest and the radiographs I'd like to see. All of it in English. And a letter from me, signed, with a direct channel: the clinic's WhatsApp, +55 47 99782-2642, and atendimento@fernandogiovanella.com.

What I ask of you. Nothing you don't already do for your own implant patients: cleaning and review at the intervals in the protocol, a radiograph when it's due, and a copy sent to me. A sinus symptom on the side of a zygomatic implant: send me the image and your note before treating it as an ordinary sinus complaint — the one place where the long implant changes the picture. And before removing anything, a call, unless it's an emergency.

If you'd rather talk it through. I'm available for a case discussion by video; write to the clinic and we'll set a time. If you disagree with my reading of an image, say so; the written-opinion rule above applies to you as much as to the patient.

Questions you may be asking yourself now

Do zygomatic implants go through the sinus?

It depends on the technique more than on the implant. Every zygomatic implant passes the sinus to reach the cheekbone; some techniques run it through the sinus, others keep it outside, along the outer wall. The lowest reported sinusitis rates belong to the second group — 0.00% in a 2024 meta-analysis, against 4.36% inside the sinus and 21.62% with the sinus slot technique.5 Here, the path is planned on your CBCT to follow that outer wall, according to your anatomy.

Can zygomatic implants fail, and how often?

Yes — any implant can. What the literature reports: a 2016 review pooling 68 studies reported 95.21% survival at twelve years1; a 2023 meta-analysis found 96.2% at six years, with an annual failure rate of about 0.7%2. Pooled numbers across thousands of patients, not a promise about yours. When one does fail it's usually removed and the plan redrawn — one reason the rule for coming back is written down above.

Can zygomatic implants be removed?

Yes. A zygomatic implant that fails to integrate, or develops an infection that doesn't settle, can be removed — by unscrewing it in most cases or, when it has integrated, with a small margin of bone. The bridge is then carried by the remaining implants while a new plan is made, or a new implant is placed later. It's surgery, not a quick visit, and one of the things that would mean coming back to the surgeon who placed it.

Are zygomatic implants permanent?

"Permanent" is the word people search for; "designed to stay" is the honest one. The implant is meant to stay in the cheekbone, and the reviews report 95–96% survival at six to twelve years12, comparable to conventional implants over five years or more3. The teeth on top are not permanent: they need cleaning, check-ups and, over the years, repairs or a replacement. The implant is meant to stay. The bridge is meant to be looked after.

Who will clean and check my implants once I'm home?

Your own dentist and hygienist. Cleaning and check-ups around implant-supported bridges are routine work for a practice that places or restores implants, and the passport tells them exactly what they're looking at. I suggest a visit every six months, and a panoramic X-ray once a year. In return I ask one thing: a copy of each X-ray, so I can follow your implants from here. One check is mine: your planned return, three to four months after surgery.

If a screw loosens, can a dentist at home tighten it?

Usually, yes. A loose prosthetic screw is the most common small repair: the right driver, through the bridge's access hole, to the torque in your passport. Neodent parts: the Straumann Group's own shops in the US, Canada, the UK and Australia24. If your dentist charges for it, the home-repair rule in the written warranty applies. Don't leave it loose: tell us, and you'll hear back the same business day.

Can I have an MRI with zygomatic implants?

Yes, under conditions — and the radiologist decides. Both makers' current zygomatic implants are listed as MR Conditional18,20,21, and the FDA's guidance is that nobody with an implanted device should have an MRI unless it has been identified as MR Safe or MR Conditional12. The exact conditions — field strength, gradient and energy limits — are printed in your passport. Tell the MRI center when you book, show them that page, and let the radiologist make the call.

References

  1. Chrcanovic BR, Albrektsson T, Wennerberg A. Survival and complications of zygomatic implants: an updated systematic review. J Oral Maxillofac Surg. 2016;74(10):1949–64. doi:10.1016/j.joms.2016.06.166 · PMID 27422530. https://pubmed.ncbi.nlm.nih.gov/27422530/ — accessed 7 October 2026.
  2. Brennand Roper M, et al. Long-term treatment outcomes with zygomatic implants: a systematic review and meta-analysis. Int J Implant Dent. 2023;9(1):21. doi:10.1186/s40729-023-00479-x · PMID 37405545. https://doi.org/10.1186/s40729-023-00479-x — accessed 7 October 2026.
  3. Moraschini V, et al. Survival and complications of zygomatic implants compared to conventional implants reported in longitudinal studies with a follow-up period of at least 5 years: a systematic review and meta-analysis. Clin Implant Dent Relat Res. 2023;25(1):177–189. doi:10.1111/cid.13153 · PMID 36373779. https://doi.org/10.1111/cid.13153 — accessed 7 October 2026.
  4. Visconti RF, Greco K, Cotticelli C, Ambrosi A, Esposito MA. Interventions for replacing missing teeth: zygomatic implants for the rehabilitation of the severely atrophic edentulous maxilla. Cochrane Database Syst Rev. 2026;7(7):CD004151. doi:10.1002/14651858.CD004151.pub4 · PMID 42489150. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004151.pub4/full — accessed 7 October 2026.
  5. Rocha RS, et al. Comparison of sinusitis rate after sinus lift procedure and zygomatic implant surgery: a meta-analysis. Oral Maxillofac Surg. 2024;28(1):63–77. doi:10.1007/s10006-023-01159-1 · PMID 37266797. https://pubmed.ncbi.nlm.nih.gov/37266797/ — accessed 7 October 2026.
  6. Felkai PP, Nakdimon I, Felkai T, Levin L, Zadik Y. Dental tourism and the risk of barotrauma and barodontalgia. Br Dent J. 2023. PMID 36707585. https://pubmed.ncbi.nlm.nih.gov/36707585/ — accessed 7 October 2026.
  7. Regulation (EU) 2017/745 on medical devices (MDR), Article 18 — implant card. EUR-Lex, CELEX:32017R0745. https://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:32017R0745 — accessed 7 October 2026.
  8. Council of European Dentists. CED Position — Implant Cards for Dental Implants (CED-DOC-2020-021-FIN-E), adopted 20 November 2020. https://www.omd.pt/content/uploads/2021/01/CED-DOC-2020-021-FIN-E.pdf — accessed 7 October 2026.
  9. Dentistry.co.uk. "Dental tourism: nine in 10 dentists have treated patients who travelled abroad for treatment" (British Dental Association survey), 14 July 2022. https://dentistry.co.uk/2022/07/14/dental-tourism-nine-in-10-dentists-have-treated-patients-who-travelled-abroad-for-treatment/ — accessed 7 October 2026.
  10. Irish Dental Association. "IDA Position on Dental Tourism" (survey of 440 dentists, 2009). https://dentist.ie/dental-tourism/ — accessed 7 October 2026.
  11. Oral Health Foundation. "The downsides of dental tourism" (citing a Which? report). https://www.dentalhealth.org/the-downsides-of-dental-tourism — accessed 7 October 2026.
  12. U.S. Food and Drug Administration. "MRI (Magnetic Resonance Imaging): Benefits and Risks". https://www.fda.gov/radiation-emitting-products/mri-magnetic-resonance-imaging/benefits-and-risks — accessed 7 October 2026.
  13. Santa Catarina Regional Dental Council (CRO-SC) — public registry search. https://cro-sc.implanta.net.br/servicosonline/Publico/ConsultaInscritos/ — accessed 7 October 2026.
  14. Federal Council of Dentistry (CFO), Brazil — public registry search. https://website.cfo.org.br/consulta-inscritos/ — accessed 7 October 2026.
  15. Chow J, Wat P, Hui E, Lee P, Li W. A new method to eliminate the risk of maxillary sinusitis with zygomatic implants. Int J Oral Maxillofac Implants. 2010;25(6):1233–40. PMID 21197502. https://pubmed.ncbi.nlm.nih.gov/21197502/ — accessed 7 October 2026.
  16. U.S. Food and Drug Administration. 510(k) Premarket Notification database — K190718, "Zygomatic Implants", JJGC Indústria e Comércio de Materiais Dentários S.A. (Neodent), Curitiba, Brazil, 2019; K232099, "GM Zygomatic Implant System", 2023; K182620, MRI compatibility of the Neodent implant system, 2019. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K190718 · https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K232099 · https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K182620 — accessed 7 October 2026.
  17. U.S. Food and Drug Administration. 510(k) Premarket Notification database — K251129, "S.I.N. Tapered Pro Conical Zygoma Implant System", S.I.N. Implant System, São Paulo, Brazil, November 2025. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K251129 — accessed 7 October 2026.
  18. U.S. Food and Drug Administration. Device database entries for the Neodent and S.I.N. zygomatic implants — MRI safety information: "MR Conditional". FDA Global Unique Device Identification Database (AccessGUDID), field "MRI safety", read through the openFDA API: https://api.fda.gov/device/udi.json?search=brand_name:Neodent+AND+device_description:zygomatic&limit=5 · https://api.fda.gov/device/udi.json?search=company_name:%22Sistema+de+Implante+Nacional%22+AND+device_description:zygomatic&limit=5 — accessed 7 October 2026.
  19. Health Canada. Medical Devices Active Licence Listing (MDALL) — licence 104259, Neodent GM Zygomatic System (2020); licences 98074 and 98075, Neodent HE and CM Zygomatic Systems (2016); licence 113168, S.I.N. Zygomatic Plus Implant (April 2025). https://health-products.canada.ca/mdall-limh/ — accessed 7 October 2026.
  20. Neodent (JJGC Indústria e Comércio de Materiais Dentários S.A., Curitiba, Brazil). Patient information on MRI safety (1.5 T and 3 T; maximum spatial gradient 4,000 gauss/cm, 40 T/m; whole-body SAR 2 W/kg; head SAR 3.2 W/kg); patient implant card, Neodent Zygoma system; Zygoma GM product information (lengths 30–55 mm; Grand Morse connection). Patient information leaflet, Neodent Zygoma Implant System (Straumann Group, Australia): https://straumann.com/content/dam/media-center/straumann/en-au/documents/leaflet/implant-card-and-patient-info-leaflet/PIL_Neodent%20Zygoma%20Implant%20System.pdf · Patient implant card: https://straumann.com/content/dam/media-center/straumann/en-au/documents/leaflet/implant-card-and-patient-info-leaflet/PIC_Neodent%20Dental%20Implant%20Card.pdf · Zygoma GM: https://www.straumann.com/neodent/en/dental-professionals/implantology/neoarch/zygoma-gm.html — read 7 October 2026.
  21. S.I.N. Implant System (São Paulo, Brazil). Instructions for use, zygomatic implants — MR Conditional: 3.0 T; maximum spatial gradient 50 T/m (5,000 gauss/cm); imaging obtained at least 30 cm from the implant or with the implant outside the RF coil; Zygomatic Plus: Ø 4.0 mm, lengths 30.0–62.5 mm in 2.5 mm steps. Instructions for use EI0089, Zygomatic Plus Implant, rev. 00, November 2025 (EU edition): https://d31hw89ycmfplm.cloudfront.net/sites/3/2026/01/EI0089-IMPLANT-ZYGOMATIC-PLUS-EN.CE_Rev.00.pdf — read 7 October 2026.
  22. DEKRA. ISO 13485:2016 certificate no. 2197607 — JJGC Indústria e Comércio de Materiais Dentários S.A. (Neodent), valid to 1 November 2027. https://straumann.com/content/dam/media-center/neodent/en/documents/certificates/iso-certificate/certificate_EN_ISO_13485_2016_2197607.pdf — read 7 October 2026.
  23. Straumann Holding AG. Media release, "Straumann increases ownership of Neodent to 100%", 7 April 2015 (full reproduction). https://www.marktpuls.ch/artikel/permalink/111805 · Dentaltown. "Straumann to Acquire 49 Percent of Neodent, Brazil's Leading Dental Implant Company", 2012. https://www.dentaltown.com/news/details/7390/straumann-to-acquire-49-percent-of-neodent-brazils-leading-dental-implant-company · Henry Schein, Inc. Form 10-Q for the quarter ended 30 September 2023 (S.I.N. acquisition, consideration US$326 million). https://www.sec.gov/Archives/edgar/data/0001000228/000100022823000052/hsic-20230930.htm — all accessed 7 October 2026.
  24. Straumann Group — Neodent online shops: United States (GM Zygomatic Implant 4.0 × 45 mm and GM Mini Conical Abutment with screw, listed in stock); Canada (GM Zygoma-S); United Kingdom; Australia. https://shop.straumann.com/neodent/us/en_us/p/109.1054 · https://shop.straumann.com/neodent/us/en_us/Implant-Lines/Grand-Morse/GM-Abutments/GM-Mini-Conical-Abutment/p/115.281 · https://shop.straumann.com/neodent/ca/en_ca/Implants-and-Abutments/Zygoma-GM/Zygomatic-Implants/GM-Zygoma-S-Implant/p/109.1103 · https://shop.straumann.com/neodent/gb/en_gb/ · https://shop.straumann.com/neodent/au/en_au/ — read 7 October 2026.
  25. Neodent — warranty programme (implants: no end date, the maker's word is "lifetime"; abutments and metallic restorations: ten years; ceramic restorations: five years) · S.I.N. Implant System — warranty programme (work performed within Brazilian territory). https://www.straumann.com/neodent/en/dental-professionals/services/customer-services/lifetime-guarantee.html · https://www.sinimplantsystem.com/lifetime-warranty/ — read 7 October 2026.

About this guide

Reviewed and approved by Dr. Fernando Giovanella, CRO-SC 8237 · Updated October 2026 · Next review: April 2027

Where the facts come from. Every number on this page comes from a primary source listed under References, with the date it was checked. The regulatory status of the Neodent and S.I.N. implant systems was read in the public databases of the U.S. FDA and Health Canada and in the manufacturers' own documents, listed under References with the date read. Explanations without a number describe how these procedures work in general; they were reviewed by Dr. Giovanella and are not a promise about any one case. The implant passport, the follow-up protocol, the warranty and the rule for who pays described on this page are commitments of the clinic, set out in your treatment contract and its written warranty. What this guide does not publish: prices, patient names, before-and-after images without consent, star ratings, or comparisons with other surgeons or countries.

Conflicts of interest. Dr. Giovanella is a paid research-and-development consultant to an implant manufacturer and is the designer of surgical instruments with patent applications pending in Brazil. The full declaration is on the editorial policy page.

How to check the registration. The public registries of the Santa Catarina Regional Dental Council and the Federal Council of Dentistry list every registered dentist in Brazil. Search "Fernando Giovanella", Santa Catarina.13,14

Found a mistake? Send it to the clinic on WhatsApp (the same button above) or by e-mail at atendimento@fernandogiovanella.com. You'll have an answer within five business days; corrections are made and dated on the page.

How this guide is written, checked and kept up to date

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